| The aim of this study was to investigate in-vitro antibacterial and antibiofilm effect of colistin,
imipenem, gentamicin, and fosfomycin alone and the various combinations against carbapenem-
resistant Pseudomonas aeruginosa (P. aeruginosa). Eight carbapenem-resistant and biofilm-
forming P. aeruginosa isolates from burn patients were collected. The mechanisms of resistance to
carbapenem were determined by the phenotypic, PCR, and Real-Time PCR assays. The minimum
inhibitory concentration (MIC) of antimicrobial agents was determined by the broth micro
dilution. To detect any inhibitory effect of antibiotics against the biofilm, the biofilm inhibitory
concentration was determined. To detect synergetic effects of the combinations of antibiotics,
the checkerboard assay and the fractional inhibitory concentration (FIC) were used. The highest
synergic effect was observed in colistin/fosfomycin and gentamicin/fosfomycin (5 of 8 isolates),
and the lowest synergic effect was found in gentamicin/imipenem and colistin/gentamicin (1
of 8 isolates). Colistin/fosfomycin, imipenem/fosfomycin, colistin/imipenem, gentamicin/
fosfomycin, and gentamicin/imipenem were shown synergic effect for 3, 2, 2, 2 and 1 isolates,
respectively. The combination of antibiotics had different effects on biofilm and planktonic forms
of P. aeruginosa. Therefore, a separate determination of inhibitory effects of the antibiotic in the
combination is necessary. Fosfomycin/colistin and fosfomycin/gentamicin were more effective
against planktonic form and fosfomycin/colistin against biofilm forms. |